Slim Medical - Abdominoplasty
Abdomioplasty - Frequently Asked Questions
Q: What is a tummy tuck, or abdominoplasty?
A: A tummy tuck or abdominoplasty involves removal of excess skin and fat in the lower abdomen via a transverse incision low in the abdomen at the bikini line. Pregnancy, weight gain and weight loss have a lasting impact on a woman’s abdomen. Only rarely does dieting and exercise fully restore the abdominal wall to its flat desirable shape after the skin and muscles have been stretched. In such cases, a tummy tuck is necessary to restore the abdomen to its previous shape.
Q: What is the difference between traditional and Avelar abdominoplasty?
A: Until recently, tummy tuck or abdominoplasty was performed in a much more invasive fashion. Traditional abdominoplasty involves the removal of skin as well as fat that overlies the muscle via undermining the fat layer and cutting it out, including everything that is inside that fat layer. Therefore, blood vessels that are vital to healing are damaged and compromised, leading to a higher risk of complications. Also, such a large excision of tissue creates empty or dead space, which further increases infectious complication risk.
Avelar abdominoplasty or tummy tuck is yielding better results and lower complications than ever before due to a technical revolution that started in Brazil about 10 years ago. Developed by a Brazilian surgeon named Dr Avelar, the new tummy tuck has several names: lipoabdominoplasty, abdominolipoplasty, the Avelar abdominoplasty, or minimally invasive abdominoplasty. This new method of Avelar abdominoplasty represents the first safe and effective fusion of cosmetic abdominoplasty and abdominal liposuction.
Unlike traditional abdominoplasty, Avelar abdominoplasty does not require the separation and elevation of the entire abdominal wall skin, fat layers and blood vessels from the abdominal muscles in order to tighten loose skin. By avoiding this process, much of the discomfort and frequency of complications associated with traditional abdominoplasty is eliminated. Instead, lipoabdominoplasty relies on the use of tumescent liposuction under local anesthesia to loosen the skin and fat layers without the need to separate any blood vessels. Lipoabdominoplasty utilizes a superficial excision of only the excess skin layer to achieve a tight abdomen. If needed, abdominal muscles are tightened through a narrow tunnel in the midline of the abdomen.
Furthermore, better cosmetic outcome can be achieved with the Avelar abdominoplasty, since liposuction is combined with the abdominoplasty, allowing improved body contouring.
Q: When is one a candidate for liposuction alone versus lipoabdominoplasty?
A: Liposuction alone is recommended if there is fat that is resistant to diet and exercise but skin tone is good. If the skin is loose (from pregnancy or weight loss), then lipoabdominoplasty would yield better cosmetic results.
Q: How is the lipoabdominoplasty carried out?
A: Since it is less invasive than traditional abdominoplasty, the Avelar abdominoplasty can be done under local (or tumescent) anesthesia. This avoids the risks and complications of general anesthesia, thereby making the procedure safer.
Liposuction is first performed to remove excess fat, leaving behind the needed matrix of connective tissue and blood vessels. A long incision is made in the bikini line just above the pubic area, and the excess skin is removed, leaving behind the underlying tissue intact. A second incision is sometimes made around the belly button. If needed, the fascia overlying the muscle is sutured in order to tighten loose or stretched out muscles. This step creates a tighter abdominal wall, and is performed if there is significant diastasis of the rectus muscle . The skin is stretched down and sutured, thereby tightening the abdomen. Usually, drains are inserted to eliminate fluid and blood buildup. An effort is made to hide the scars in the bikini area.
Q: Who is a good candidate for tummy tuck?
A: The ideal candidate for tummy tuck should meet most of the following criteria:
- Is close to her ideal body weight.
- Wants to remove specific areas of loose skin or fat that have been resistant to dieting and exercise.
- Has stable weight.
- Has good skin tone.
- Is emotionally stable.
- Understands the risks of abdominoplasty surgery and scarring.
- Has realistic expectations of significant improvement, but realizes that perfection cannot be achieved.
Q: Who should not have a tummy tuck?
A: Anyone with significant medical conditions, such as diabetes, high blood pressure, poor circulation, heart, lung, or liver conditions. Anyone that smokes, has a family history of blood clots, or takes certain medications should also not have abdominoplasty.
Q: What are the post operative expectations of recovery?
A: They vary from person to person, but a general ecpectation is as follows:
- Length of surgery: 3-4 hours
- Pain level: Moderate, requiring 3-8 days of pain medication
- Numbness: 6 months or more; some areas may remain permanently numb
- Drains: Removed between 2-10 days
- Stitches: Dissolvable
- Time off work: Return to desk job in 1-2 weeks
- Exercise: 4-6 weeks
- Final result: Apparent after the scar heals in 6-12 months